The Treatment of Restless Psychotics with Methotrimeprazine (Veractil)

1961 ◽  
Vol 107 (449) ◽  
pp. 783-786 ◽  
Author(s):  
David Muller
Keyword(s):  
Side Effects ◽  
Trigeminal Neuralgia ◽  
Effective Dose ◽  
Clinical Improvement ◽  
Statistical Significance ◽  
Rapid Review ◽  
Controlled Study ◽  
Working Capacity ◽  
Psychiatric Conditions

Since the introduction of methotrimeprazine (Veractil) to psychiatry in 1956 by the French workers, Sigwald, Henne, Bouttier, Raymoneaud and Quetin (1), this drug has been used here and on the Continent for the treatment of various psychiatric conditions with varying and inconsistent success. A rapid review of some examples in the literature will suffice to illustrate this. Deschamps and Madre (2) stated that the drug was more rapidly effective and more powerful than chlorpromazine (Largactil). Gayral et al. (3) reported on their findings in 409 patients, most of them (304) out-patients, and the majority (316) with depression: it was considered that Veractil was not an adequate substitute for electroplexy (E.C.T.) in depression. Larue and Gosselin (4) treated 82 patients with a variety of disorders including 2 cases of trigeminal neuralgia, with marked success. Letailleur, le Borgne and Lebrun (5) reported the side-effects of drowsiness and fainting to be relatively common, but with no true Parkinsonism, in a series of 75 patients of which they regarded 36 as cured and 25 as improved. Baruk, Launay and Roberti (6) claimed good results, not only in depression, as stated by others, but also in obsessive and digestive neuroses; and in patients with syndromes in which other neuroleptics were usually without effect. Deschales, Lanteri-Lausa and Fargeon (7) however concluded that Veractil was no more efficacious than other neuroleptics though they preferred it for depressives: it could usefully be combined with E.C.T. in these cases but it could not replace it. Baker and Thorpe (8) found no difference in comparison with Largactil while treating deteriorated schizophrenics, except that the effective dose of Veractil was only two-thirds that of Largactil. Leitch and Seager (9) found no statistical significance in a placebo-controlled study comparing Veractil, Largactil, acepromazine and promazine. But Quinn, Johnston, Latner and Kiloh (10) again reported a 42 per cent. clinical improvement in patients given Veractil compared with Largactil and a placebo in 146 schizophrenics using the working capacity in males and the degree of deterioration in females as pointers for assessment.

scholarly journals Trigeminal Neuralgia: Outcomes after Gamma Knife Radiosurgery

2009 ◽  
Vol 36 (1) ◽  
pp. 78-82 ◽  
Author(s):  
Henri Knafo ◽  
Brendan Kenny ◽  
David Mathieu
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Gamma Knife ◽  
Cox Regression ◽  
Statistical Significance ◽  
Gamma Knife Radiosurgery ◽  
Cox Regression Analysis

Background:Trigeminal neuralgia (TN) often remains difficult to treat despite multiple available medications, and can severely impact on the quality of life of affected patients. Gamma knife radiosurgery has recently emerged as a minimally-invasive alternative to surgery for patients suffering from drug-resistant TN. The goal of this study was to report the short-term efficacy of gamma knife radiosurgery for TN and assess its impact on the quality of life of patients treated in the first 18 months of our experience.Methods:Patients with medically-refractory TN or with unacceptable drug side effects were considered for radiosurgery. A maximum dose of 80 Gy was administered to the affected nerve using a single 4-mm isocenter. Follow-up assessments were made at 2, 4 and 6 months, with evaluation of pain relief, drug reduction and quality of life. Factors impacting treatment response were assessed using Cox regression analysis.Results:A total of 67 patients were treated. Significant pain relief was seen in 77.6% of patients, including 32.6% who became pain-free. Patients were able to discontinue all medications in 34.3% or reduce drug intake by more than 50% in an additional 28.4% of cases. No variable was found to predict pain relief although older age (>66 years) approached statistical significance. Sensory side effects were seen in 14.9% of patients. Quality of life improved in the majority of patients after radiosurgery.Conclusions:Gamma knife radiosurgery is a safe and effective management alternative for trigeminal neuralgia, providing good or excellent pain relief and improvement in quality of life in the majority of patients with few side effects.

scholarly journals The PATCH trial: efficacy and safety of 5% lidocaine-medicated plaster for the treatment of patients with trigeminal neuralgia: a study protocol for a multicentric, double-blind, enriched enrolment randomised withdrawal, vehicle-controlled study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045493
Author(s):  
Chunmei Zhao ◽  
Niti Shrestha ◽  
Hongbing Liu ◽  
Ying Shen ◽  
Lan Meng ◽  
...  
Keyword(s):  
Side Effects ◽  
Trigeminal Neuralgia ◽  
Study Protocol ◽  
Controlled Trial ◽  
Treatment Phase ◽  
Treatment Method ◽  
Controlled Study ◽  
Open Label ◽  
Double Blind ◽  
Patch Trial

IntroductionTrigeminal neuralgia (TN) is characterised by a sudden, severe, electric shock like paroxysmal pain, which is almost always associated with triggers. Carbamazepine is the first-line medical management of TN. However, side effects are common. Currently, there is no ideal treatment for TN. Since there is a known abnormality of Na+ channels in the trigger zone, 5% lidocaine-medicated plaster (LMP), which can block the Na+ channels on Aδ and C fibres, is an effective treatment method in many chronic pain conditions. A case report has found the benefit of LMP for the treatment of TN without any side effects. Whether LMP is an option for the treatment of TN is worth exploring.Methods and analysisThe PATCH trial is a double-blind, enriched enrolment with randomised withdrawal, vehicle-controlled trial, aiming to explore the effects and safety of LMP in patients with TN. There is a 3-week initial open-label phase, followed by a 4-week double-blind treatment phase for responders. In the double-blind phase, patients will have to withdraw from this PATCH study if they meet one of the following criteria for treatment failure such as: >50% increase in pain intensity or paroxysms, lack of efficacy or side effects. The primary outcome will be the number of treatment failures. Adverse events will also be monitored throughout the study.Ethics and disseminationThis study protocol has been approved by the Institutional Review Board of Beijing Tiantan Hospital (approval number: KY 2020-102-02). The results will be disseminated in international academic meetings and published in peer-reviewed journals.Trial registration numberNCT04570293.

A Comparative Ex Vivo Study of Plasminogen Activators and Proteases for Fibrinolytic Activity and Side Effects in Rabbits

1977 ◽  
Vol 37 (01) ◽  
pp. 154-161 ◽  
Author(s):  
B. A Janik ◽  
S. E Papaioannou
Keyword(s):  
Side Effects ◽  
Effective Dose ◽  
Fibrinolytic Activity ◽  
Ex Vivo ◽  
Plasminogen Activators ◽  
Assay System ◽  
Coagulation Parameters ◽  
Ex Vivo Assay

SummaryUrokinase, streptokinase, Brinase, trypsin, and SN 687, a bacterial exoprotease, have been evaluated in an ex vivo assay system. These enzymes were injected into rabbits and the fibrinolytic activity as well as other coagulation parameters were measured by in vitro techniques. Dose-response correlations have been made using the euglobulin lysis time as a measure of fibrinolytic activity and the 50% effective dose has been determined for each enzyme. Loading doses, equal to four times the 50% effective dose, were administered to monitor potential toxicity revealing that Brinase, trypsin, and SN 687 were very toxic at this concentration.Having established the 50% effective dose for each enzyme, further testing was conducted where relevant fibrinolytic and coagulation parameters were measured for up to two days following a 50% effective dose bolus injection of each enzyme. Our results have demonstrated that urokinase and streptokinase are plasminogen activators specifically activating the rabbit fibrinolytic system while Brinase, trypsin and SN 687 increase the general proteolytic activity in vivo.The advantages of this ex vivo assay system for evaluating relative fibrinolytic potencies and side effects for plasminogen activators and fibrinolytic proteases have been discussed.

Diffusion tensor imaging reveals microstructural differences between subtypes of trigeminal neuralgia

2020 ◽  
Vol 133 (2) ◽  
pp. 573-579 ◽  
Author(s):  
Matthew S. Willsey ◽  
Kelly L. Collins ◽  
Erin C. Conrad ◽  
Heather A. Chubb ◽  
Parag G. Patil
Keyword(s):  
Diffusion Coefficient ◽  
Diffusion Tensor Imaging ◽  
Trigeminal Neuralgia ◽  
Apparent Diffusion Coefficient ◽  
Diffusion Tensor ◽  
Statistical Significance ◽  
Region Of Interest ◽  
Pain Syndrome ◽  
Radial Diffusivity ◽  
Apparent Diffusion

OBJECTIVETrigeminal neuralgia (TN) is an uncommon idiopathic facial pain syndrome. To assist in diagnosis, treatment, and research, TN is often classified as type 1 (TN1) when pain is primarily paroxysmal and episodic or type 2 (TN2) when pain is primarily constant in character. Recently, diffusion tensor imaging (DTI) has revealed microstructural changes in the symptomatic trigeminal root and root entry zone of patients with unilateral TN. In this study, the authors explored the differences in DTI parameters between subcategories of TN, specifically TN1 and TN2, in the pontine segment of the trigeminal tract.METHODSThe authors enrolled 8 patients with unilateral TN1, 7 patients with unilateral TN2, and 23 asymptomatic controls. Patients underwent DTI with parameter measurements in a region of interest within the pontine segment of the trigeminal tract. DTI parameters were compared between groups.RESULTSIn the pontine segment, the radial diffusivity (p = 0.0049) and apparent diffusion coefficient (p = 0.023) values in TN1 patients were increased compared to the values in TN2 patients and controls. The DTI measures in TN2 were not statistically significant from those in controls. When comparing the symptomatic to asymptomatic sides in TN1 patients, radial diffusivity was increased (p = 0.025) and fractional anisotropy was decreased (p = 0.044) in the symptomatic sides. The apparent diffusion coefficient was increased, with a trend toward statistical significance (p = 0.066).CONCLUSIONSNoninvasive DTI analysis of patients with TN may lead to improved diagnosis of TN subtypes (e.g., TN1 and TN2) and improve patient selection for surgical intervention. DTI measurements may also provide insights into prognosis after intervention, as TN1 patients are known to have better surgical outcomes than TN2 patients.

EFFECTS OF “HOE HOA TAN II” REMEDY IN THE TREATMENT OF INTERNAL HAEMORROHIDS GRADE I, II AND III

2015 ◽  
pp. 80-85
Author(s):  
Van Anh Nguyen ◽  
Van Nhan Le ◽  
Nguyen Nhu Phuong Phan
Keyword(s):  
Side Effects ◽  
Key Words ◽  
Patient Group ◽  
Controlled Study ◽  
Therapeutic Effects ◽  
Radix Angelicae Sinensis ◽  
Randomised Controlled Study ◽  
Citrus Deliciosa ◽  
Randomised Controlled ◽  
Angelicae Sinensis

Objectives: To investigate and evaluate the therapeutic effects of Hoe hoa tan II in the treatment of internal haemorroids grade I, II and III. Ingredients of the remedy include: Hoe Hoa (Styphonolonium japonicum), Chi xac (Fructus citri Aurantii), Hau phac (Magnolia offinalis), Tran bi (Citrus deliciosa Tenore), Thuong thuat (Atractylodes lancea), O mai (Armeniaca vulgaris Lamk), Cam thao (Clycyrrhiza uralensis), Duong quy (Radix Angelicae Sinensis). Subjects and methods: Randomised controlled study (RCT) has been conducted on 60 patients which were divided into two groups, i.e. the first 30 patient group were treated with Hoe hoa tan II remedy 20 g, and the second 30 patient group were treated with Daflon 500 mg in the course of 14 days. Results: Study showed that Hoe hoa tan II has helped improve symptoms of internal haemorroids grade I, II and III such as bleeding, anal exudation, pain, reducing the size of the haemorroid tissues. The remedy has been shown to have the most significant effect on relieving constipation which is typical in haemorroids. The study also revealed no unwanted effects caused by this formula. Conclusion: Hoe hoa tan II can be therapeutically used to treat internal haemorroids grade I, II and III without causing any serious side effects. Key words: Hoe hoa tan II, internal haemorroids grade I, II, III.

Clinical Study of Qingpeng Ointment Treatment of Shoulder-Hand Syndrome After Cerebral Hemorrhage During the Rehabilitation Period

2020 ◽  
Vol 23 ◽  
Author(s):  
Ruihuan Pan ◽  
Shanshan Ling ◽  
Haodong Yang ◽  
Yan Huang ◽  
Lechang Zhan ◽  
...  
Keyword(s):  
Treatment Group ◽  
Cerebral Hemorrhage ◽  
Clinical Medicine ◽  
External Rotation ◽  
Statistical Significance ◽  
Hand Function ◽  
Tibetan Medicine ◽  
Controlled Study ◽  
Control Group ◽  
The Difference

Background: Shoulder-hand syndrome (SHS) refers to a syndrome causing sudden edema, shoulder pain and limited hand function. Qingpeng ointment, a kind of Tibetan medicine, can reduce swelling, relieve pain, tonify stagnation and clear the meridians, which is consistent with the pathological mechanism of SHS after stroke. Therefore, if clinical trials can be used to explore the effectiveness of Qingpeng ointment for treatment of poststroke SHS and promote its application in clinical medicine, this is of specific significance for the treatment of poststroke SHS. Objective: To investigate the clinical efficacy and safety of Qingpeng ointment in the treatment of poststroke SHS. To provide an objective basis for a better therapeutic treatment for poststroke SHS． Method: A prospective, randomized, controlled study was conducted. This study recruited 120 patients with poststroke SHS who met the inclusion criteria. They were randomized into the treatment group and the control group, with 60 patients allocated to each group. The treatment group received routine medical treatment and rehabilitative care after using the Qingpeng ointment, while the patients in the control group received only routine treatment without the ointment. All patients received clinical assessment with the Visual Analogue Scale (VAS), measurement of the range of motion (ROM) of the upper-limb joints, the Fugl-Meyer Assessment of Upper Extremity (FMA-U) and the Modified Barthel Index Score (MBI) before and after the whole treatment. Results: After 4 weeks of treatment, the VAS scores of both groups were decreased significantly (P＜0.05), and the difference between the two groups was statistically significant (P < 0.05). There is no statistical significance for the difference between the treatment group and control group in terms of the FMA-U and MBI scores and the forward bend, backward, outstretch, external rotation and pronation angles after treatment. The increases in the values of VAS, FMA-M and MBI in the treatment group were greater than those in the control group, and the difference was statistically significant (P < 0.05). The increases in the values of the forward bend, outreach and external rotation angles in the treatment group were greater than those in the control group, and the difference was statistically significant (P < 0.05). Conclusion: The treatment group showed better results than the control group in terms of the relief of pain symptoms, the improvement of motor function and the improvement of the activities of daily living for patients with shoulder-hand syndrome after cerebral hemorrhage. Qingpeng ointment is effective and safe in treating poststroke SHS.

scholarly journals Transcutaneous Electrical Acupoint Stimulation Reduces Postoperative Analgesic Requirement in Patients Undergoing Inguinal Hernia Repair: A Randomized, Placebo-Controlled Study

2021 ◽  
Vol 10 (1) ◽  
pp. 146
Author(s):  
Mateusz Szmit ◽  
Siddarth Agrawal ◽  
Waldemar Goździk ◽  
Andrzej Kübler ◽  
Anil Agrawal ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Inguinal Hernia ◽  
Side Effects ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Adverse Drug Events ◽  
Controlled Trial ◽  
Controlled Study ◽  
Anesthetic Technique ◽  
Analgesic Requirement

Given the rising rate of opioid-related adverse drug events during postsurgical pain management, a nonpharmacologic therapy that could decrease analgesic medication requirements would be of immense value. We designed a prospective, placebo-and-randomized controlled trial to assess the clinical effect of transcutaneous acupoint electrical stimulation (TEAS) on the postoperative patient-controlled analgesia (PCA) requirement for morphine, as well as side effects and recovery profile after inguinal hernia repair. Seventy-one subjects undergoing inguinal hernia repair with a standardized anesthetic technique were randomly assigned to one of three analgesic treatment regimens: PCA + TEAS (n = 24); PCA + sham-TEAS (no electrical stimulation) (n = 24), and PCA only (n = 23). The postoperative PCA requirement, pain scores, opioid-related side effects, and blood cortisol levels were recorded. TEAS treatment resulted in a twofold decrease in the analgesic requirement and decreased pain level reported by the patients. In addition, a significant reduction of cortisol level was reported in the TEAS group at 24 h postoperatively compared to the sham and control groups. We conclude that TEAS is a safe and effective option for reducing analgesic consumption and postoperative pain following inguinal hernia repair.

Diagnostic accuracy of enthesis ultrasound in the diagnosis of early spondyloarthritis

2010 ◽  
Vol 70 (3) ◽  
pp. 434-439 ◽  
Author(s):  
Eugenio de Miguel ◽  
Santiago Muñoz-Fernández ◽  
Concepción Castillo ◽  
Tatiana Cobo-Ibáñez ◽  
Emilio Martín-Mola
Keyword(s):  
New York ◽  
Diagnostic Accuracy ◽  
Statistical Significance ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Controlled Study ◽  
Diagnostic Classification ◽  
Hla B27 ◽  
Cross Sectional ◽  
Ultrasound Score

ObjectiveTo determine the sensitivity and specificity of enthesis ultrasound for the diagnostic classification of early spondyloarthritis.MethodsA cross-sectional, blinded and controlled study. Standardised bilateral ultrasound of six entheses (Madrid sonography enthesitis index (MASEI)) was performed. Accepted diagnostic classification criteria were used as the gold standard. Validity was analysed by receiver operating characteristic (ROC) curves. Values of p<0.05 were considered significant.Results113 early spondyloarthritis patients were included (58 women/55 men), 57 non-inflammatory control individuals (29 women/28 men) and 24 inflammatory control individuals (11 women/13 men). The evolution time of spondyloarthritis was 10.9±7.1 months. At least some grade of sacroiliitis on x-ray was present in 59 patients, but only five fulfilled the radiographic sacroiliitis New York criteria. Human leucocyte antigen B27 (HLA-B27) was positive in 42% of patients. No statistical differences were found for the enthesis score among diagnostic spondyloarthritis subtypes form of presentation (axial, peripheral or mixed) or HLA-B27 positivity. The MASEI score achieved statistical significance for gender. The ultrasound score was 23.36±11.40 (mean±SD) in spondyloarthritis patients and 12.26±6.85 and 16.04±9.94 in the non-inflammatory and inflammatory control groups (p<0.001), respectively. The ROC area under the curve was 0.82, and a cut-off point of ≥20 points achieved a likelihood ratio of 5.30 and a specificity of 89.47%.ConclusionsEntheses are affected early in spondyloarthritis, and the incidence of involvement is higher in men and independent of the spondyloarthritis diagnostic subtype, HLA-B27 status or presentation pattern. The enthesis ultrasound score seems to have diagnostic accuracy and may be useful for improving the diagnostic accuracy of early spondyloarthritis.

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